April 17, 2021

Let’s just jump right into this week’s question.

Hello Nick, I am a senior with original Medicare, a supplement and RX plan. I have been reading your article in the L.S. paper about evaluating whether an advantage plan would really benefit my cost and service wise.

I have dentures, so I don’t need dental; I do wear hearing aids and glasses, and I have 6 prescription drugs.

My two biggest concerns are – will it save me money; and will my current hospital and doctors remain in network? Do I have to get referrals for everything?

That is why I did not sign for an advantage HMO way back when I was eligible for Medicare.

Thank you for the opportunity to ask questions from a real person.

I love this question this week and I usually answer two questions but this week I think this one packs a lot of good info that I get asked frequently. Let us unpack this question together.

The person that asked this question was paying close to $2,400 per year between their medical supplement plan, along with paying for a prescription drug plan along with no dental help, no vision – eyewear help or hearing aid benefit.

So moving into a Medicare Advantage plan with a $0 monthly premium would immediately save $2,400 a year in premiums.

Make sure before you make any changes to any plan, that you have the agent check to see if your primary care doctor and any specialists that you see are in their network as well as your preferred hospital. With the plan that I was able to suggest to this person, there are no referrals needed to see a specialists and that leads into my next response about the HMO plan. Many companies did not offer any PPO network plans when Medicare Advantage plans first came out, those types of plans are now plentiful.

In response to the dental and hearing aids, the plan I referred has a $1,000 worth of comprehensive coverage per year, not per se dental coverage but an added perk, along with free cleanings, X-rays and fluoride treatments included. Hearing benefits are also included, $375 – $2075 copay for hearing aids which can easily range from around $600 all the way up to $12,000 or more for hearing aids. There is also coverage for eyeglasses that covers up to $150 for frames and covers standard single, bifocal, trifocals, or progressive lenses are covered in full. The lenses are the most expensive part of getting eyeglasses.

And for the question about the 6 prescription drugs, in this particular case all were covered for $0 if the person would allow the pharmacy to mail a 90 day supply at one time to their residence.

So the short answer to that question was in this case, yes, there is a potential for a very large savings over the course of a year, along with a lot of added benefits that this person did not have before.

Will your question be the one that gets answered next week? It could be if you just ask me what’s on your mind about Medicare.

Until next week stay safe and stay informed.
Nick Swearngin
Licensed Sales Representative